Although supramalleolar osteotomy is the main joint-preserving method for the treatment of varus ankle osteoarthritis, it tends to be ineffective when ankle osteoarthritis presents in combination with an excessive talar tilt angle. The purpose of this study was to present a new surgical technique, supramalleolar osteotomy combined with lateral ligament reconstruction and talofibular immobilization, for the treatment of varus ankle osteoarthritis with an excessive talus tilt angle and to evaluate the clinical and radiological results.From January 2013 to October 2016, a total of 17 patients with 17 cases of varus ankle arthritis with excessive talar tilt angles (larger than 7.3°) underwent surgical treatment using our new technique. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical ankle-hindfoot scale and a visual analogue scale (VAS) were used to evaluate ankle function and pain before surgery and at the last follow-up. The medial distal tibial angle (MDTA), anterior distal tibial angle (ADTA), talar tilt angle (TTA), and hindfoot moment arm values (HMAVs) were evaluated on weight-bearing radiographs acquired preoperatively and at the last follow-up.The AOFAS score improved significantly from 45.8 ± 2.1 before surgery to 84.8 ± 1.8 after surgery (p < 0.001), and the VAS score decreased from 4.9 ± 0.4 to 1.1 ± 0.2 (p < 0.001). The MDTA, TTA, and HMAV changed from 80.9° ± 0.4° to 90.1° ± 0.4°, 11.7° ± 0.6° to 1.4° ± 0.3°, and 12.6 mm ± 0.8 mm to 4.2 mm ± 0.6 mm, respectively (each p < 0.001). The ADTA showed no obvious change (p = 0.370). The staging of 11 cases (65%) improved. Intramuscular vein thrombosis of the lower limbs occurred in 1 patient 1 week after surgery, and superficial infection occurred in 1 patient.Supramalleolar osteotomy combined with lateral ligament reconstruction and talofibular immobilization can correct the load of the weight-bearing ankle and effectively improve the ankle function. As the talar tilt angle can be significantly improved after surgery, this technique can be used for the treatment of varus ankle osteoarthritis with an excessive TTA.
To investigate the capability of the bone regeneration of poly (3-hydroxybutyrate-co-3-hydroxyvalerate/sol-gel bioactive glass (PHBV/SGBG) composite porous scaffold.PHBV/ SGBG composite porous scaffold was implanted into the segmental radial bone defect of the New Zealand white rabbits, PHBV/hydroxylapatite (PHBV/HA) as experimental control. The degradability, biocompatibility, and bone regeneration capability of the implants were evaluated through radiological, histological, computerized graphic, and biomechanical analysis.The new bone formation occurred as early as 4 weeks after implantation of PHBV/SGBG composite porous scaffold. The defect was filled with new bone 8 weeks after the implantation, and was completely repaired 12 weeks after operation. The new bone had normal bone structure and the medullar cavity regenerated. The biomechanical study showed that the anti-compression force of radial specimen in PHBV/SGBG groups was significantly higher than in PHBV/ HA groups (P < 0.05), but no significant difference existed between PHBV/SGBG group and autograft bone group (P>0.05). The PHBV/SGBG composite porous scaffold degraded no sooner than 4 weeks after the implantation and most of scaffold was absorbed after 12 weeks. The proportion of the scaffold to new bone decreased from 60% by week 4 to 8% by week 12.PHBV/SGBG composite porous scaffold is a degradable bone substitute. It can achieve early bone generation and complete repair. It can be used as an ideal scaffold for tissue-engineering bone.
The main objective is to explore the diagnostic value of magnetic resonance imaging (MRI) scan, multislice spiral computed tomography (MSCT) three-dimensional reconstruction combined with plain film X-ray in spiral injuries.By means of retrospective study, the data of 100 patients with spiral injury treated in our hospital from January 2020 to December 2021 were retrospectively analyzed, and all patients received MRI scan, MSCT three-dimensional reconstruction, and plain film X-ray examination, and by taking the operation results as the reference, the diagnostic results of different diagnostic modalities were analyzed, and the accordance rates (diagnostic result/surgical result × 100%) of the three diagnostic modalities and their combination were calculated, respectively.Among the 100 patients, 52 cases (52%) had a fracture at the anterior column of the spine, 28 cases (28%) had a fracture at the middle column of the spine, and 20 cases (20%) had a fracture at the posterior column of spine; 24 cases (24%) had simple flexion compression fracture, 60 cases (60%) had burst fracture, 6 cases (6%) had seat belt fracture, and 10 cases (10%) had fracture dislocation. The accordance rate of combined diagnosis for fracture site was 100%, and that for fracture type was 98.0%; MRI could visualize bone marrow injuries, ligamentous injuries, soft tissue injuries, and nerve root injuries that could not be visualized on X-ray plain films, and 3D reconstruction with MSCT could clearly demonstrate the 3D relationship of spinal fracture displacement, fracture line orientation, and spinal injury.Plain film X-ray is the basic method for diagnosing spinal injuries, while MRI and MSCT have their unique advantages in this regard, and patients with a negative result of X-ray plain film can be examined by MRI and MSCT to observe the spinal injury comprehensively.
Objective: To introduce a robot-assisted modified method of sacroiliac screw path planning in order to reduce the incidence of screw misplacement. Methods: The study involved 13 patients suffering from posterior pelvic injuries treated by percutaneous sacroiliac screw in Yantai Shan Hospital from August 2016 to May 2018. The patients included 9 males and 4 females, aged from 18 to 70 years (mean age 46.2 years). Causes of injury were traffic accidents (n=7), crushing injury (n=4) and fall from height (n=2). According to AO classification, 8 cases were classified with type B fractures (3 with type B1 and 5 with type B2), and 5 cases with type C fractures (2 with type C1, 1 with type C2, 2 with type C3). All the patients were treated by robot-assisted percutaneous sacroiliac screws (AO cannulated screws with a diameter of 7.3 mm) with an improved method of screw path planning. The screw placement time, blood loss, postoperative neurological, vascular and visceral function etc were observed. X-ray and CT were checked in the follow-up after the operation. Visual analogue scale (VAS) score was used to assess the pain degree of patients one week after the surgery. Results: All the sacroiliac screws were successfully implanted once with the robot-assisted improved method of screw path planning. The mean placement time of single screw was 15.9 min and the mean blood loss for single screw placement was less than 1 ml. No clinical manifestations of injuries of blood vessels, internal organs and lumbosacral nerve was found after the operation. The postoperative X-ray films and CT showed that none of the sacroiliac screws wore out the sacral body or the sacral wing's frontal cortex. Also, it was found that none of the sacroiliac screws strayed into the sacral canal and the intervertebral space. The mean VAS score decreased from preoperative 6.9 (4-10) to postoperative 1.8(0-3). Conclusion: The robot-assisted improved method of screw path planning contributes to safe and accurate sacroiliac screw placement.目的： 介绍一种机器人辅助下改良的骶髂螺钉路径规划方法，以进一步降低错误置钉的发生率。 方法： 对2016年8月至2018年5月山东烟台市烟台山医院骨创伤科收治的13例骨盆损伤患者的临床资料进行分析。其中男9例，女4例；年龄18～70岁，平均46.2岁。致伤原因：交通伤7例，挤压伤4例，高处坠落伤2例。按AO分型：B型8例(B1型3例，B2型5例)，C型5例(C1型2例，C2型1例，C3型2例)。针对后环损伤，采用闭合复位机器人辅助下改良的路径规划方法引导经皮骶髂螺钉(AO直径7.3 mm的空心钉)内固定。术中观察，术后随访，对所有病例行X线片和CT复查，术后1周进行疼痛视觉模拟评分(VAS评分)。 结果： 本组所有骶髂螺钉均为机器人辅助下按改良规划一次性顺利置入。单枚螺钉置入时间平均15.9 min，单枚螺钉置入出血量平均<1 ml。所有病例术后均未出现血管、内脏、腰骶神经损伤的临床表现。术后X线片和CT显示，骶髂螺钉均未穿破骶骨体及骶骨翼前缘皮质，也未进入骶管、椎间隙，全程均于骶髂骨性安全区内走行。VAS评分由术前平均6.9分(4～10分)降至术后平均1.8分(0～3分)。 结论： 采用机器人辅助下改良的路径规划方法有助于精准安全地置入骶髂螺钉。.
Serum amyloid A (SAA) is regarded as an important acute phase protein involved in tumor progression and metastasis. However, at present there is no evidence of its involvement in osteosarcoma. The present study aimed to investigate the effect of SAA on the invasion of osteosarcoma cells. The effects of SAA on the migration and invasion of osteosarcoma cells were detected using scratch wound healing and transwell assays, respectively. The expression of αvβ3 integrin was detected at the protein and mRNA levels in U2OS cells. Agonists, inhibitors or siRNA of formyl peptide receptor like‑1 (FPRL‑1), mitogen‑activated protein kinases and αvβ3 integrin were used to investigate the mechanism underlying the effects of SAA on the regulation of U2OS cell migration and invasion. The present study revealed that SAA promoted osteosarcoma cell migration and invasion. SAA upregulated the expression of αvβ3 integrin in a concentration‑ and time‑dependent manner. When inhibiting αvβ3 integrin with its antagonist, the migration and invasion abilities of the U2OS cells were markedly inhibited. SAA‑induced αvβ3 integrin production was significantly downregulated by inhibiting FPRL‑1 with siRNA and inhibitors. The present study also found that extracellular signal‑regulated kinase (ERK) 1/2, but not c‑Jun N‑terminal kinase or p38, was important in this process. These findings demonstrated that SAA regulated osteosarcoma cell migration and invasion via the FPRL‑1/ERK/αvβ3 integrin pathway.
The purpose of this study was to investigate the correlation between single necleotide polymorphisms (SNPs) of human epidermal growth factor receptor-2 (HER2) gene with osteosarcoma susceptibility in Chinese Han population.90 patients with osteosarcoma and 100 healthy controls who were frequency-matched with the former by age and gender were enrolled for a case-control study. 5 SNPs of HER2, namely rs2952155, rs1810132, rs2952156, rs1136201 and rs1058808, were tested by Sequenom time of flight mass spectrometry technique. The linkage disequilibrium and haplotype were analyzed using haploview software. The risk intensity of osteosarcoma was expressed by odds ratio (OR) with 95% confidence interval (CI) which was calculated by chi-squared text. Hardy-Weinberg equilibrium (HWE) was also evaluated by chi-squared text.HER2 gene rs1136201 and rs1058808 polymorphisms were associated with the increased risk of osteosarcoma (P=0.04 and 0.02, respectively). Allele G in rs1136201 was 1.67 higher risk for osteosarcoma in cases than the control group (OR=1.67, 95% CI=1.11-2.51) and G allele of rs1058808 polymorphism also significantly increased osteosarcoma susceptibility (OR=2.06, 95% CI=1.27-3.22). The haplotype analysis showed that haplotype C-T-G-G might be a susceptible haplotype to osteosarcoma (OR=1.74, 95% CI=1.01-3.00). HWE test was eligible in controls (P>0.05).HER2 gene rs1136201 and rs1058808 polymorphisms and haplotype C-T-G-G may be related to osteosarcoma susceptibility in Chinese Han population, indicating that the interaction of gene polrmorphism plays an role in osteosarcoma risk.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)